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Brief Well-Child Visit Inadequate for ID of Autism Risk

Typical behaviors often exceed atypical ones and mislead clinicians in brief assessments

MONDAY, Jan. 12, 2015 (HealthDay News) — The 10 to 20 minutes of a typical well-child visit isn’t enough time to reliably detect a young child’s risk of autism, according to new research published online Jan. 12 in Pediatrics.

While at the University of Utah in Salt Lake City, Terisa Gabrielsen, Ph.D., from Brigham Young University in Provo, Utah, and colleagues videotaped two 10-minute segments of children, aged 15 to 33 months, while they underwent three assessments for autism, including the Autism Diagnostic Observation Schedule. The 42 children included 14 already diagnosed with early signs of an autism spectrum disorder, 14 without autism but with suspected language delays, and 14 who were typically developing. The researchers then showed the videos to two psychologists who specialized in autism spectrum disorders. These experts rated typical and atypical behaviors observed, and determined whether they would refer that child for an autism evaluation.

The researchers found that 11 percent of the autistic children’s video clips showed atypical behavior, compared to 2 percent of the typically developing children’s video clips. But that meant 89 percent of the behavior seen among the children with autism was noted as typical, the study authors noted. When the autism experts picked out who they thought should be referred for an autism assessment, they missed 39 percent of the children with autism.

“We were surprised to find that even children with autism were showing predominantly typical behavior during brief observations,” Gabrielsen told HealthDay. “A brief observation doesn’t allow for multiple occurrences of infrequent atypical behavior to become evident amidst all the typical behavior.”

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